I knew a couple of 20something guys who pulled that stunt, pretending to be doctors and offering free breast exams in bars. True story. Like the other posters above, I can't feel sorry for anyone stupid enough to fall for it.

Count me in with Anon 437 (insofar as slinking back into my cave o'shame when I am done here) but the women were idiots and the faux physician is a male. Sorry to be non-PC, but all the surgery and hormones in the world do not change one's DNA or gender. All this does is allow a person to pretend to be a member of the opposite gender with a really good costume of artifical parts and chemistry.

For the record, I don't "hate" these poor folks, but I do pity them and find the surgeries and treatments a total waste of medical resources.

Wow, a couple of people took this a little too seriously. I reread the artical and did not feel it was transphobic at all nor did I think his title for the blog was offensive. Life is serious enough and to be picking apart things to find negativity is kind of silly. I work with a lot of transgender clients and knowing them pretty well, I can tell you they would have got a kick out of this article. I know I did more so at the women that were getting breast exams at a bar, weren't they a little suspicious. LOL

Good effing god people! Calm the eff down! Is this your first Dr. Grumpy post IN LIFE? For that alone you should be flogged.

Say it with me now, very slowly: Tongue. In. Cheek.

And any woman who would consent to a breast exam in a BAR regardless of WHO is doing it should soundly thrashed about the head and neck. Gah!

Transphobia - are you kidding me? That's all anyone got out of this article? Not the history of larceny? Not the posing as a physician? Not that stuff huh?

We should excuse this person because they're transgendered? Not for real. You break the law, you break the law, regardless of the private parts you were born with and had changed because you didn't like them or WHATEVER.

I'm clearly on a different wave length from the rest of your readers. The part of the article I enjoyed the most was the pseudonym: Berlyn Aussieahshowna. And it turned out to be bogus??!! I'm shocked. Shocked.

This seems like a good time to point out the recent National Transgender Discrimination Survey on Health and Health Care. Out of 7,000 respondents, 19% reported being refused care, 28% were subjected to verbal harassment and a whopping 2% were victims of physical violence. All for having the audacity to see a doctor while trans.

First of all-- the story's hilarity/facedesckery (is that a word?) stands on its own, regardless of the gender identification of the perpetrator.

Second-- the transphobia in the article is apparent in two ways. First, it makes the perpetrator's identity relevant. Second, said perp identifies as male, and it is transphobic to disregard their stated identification. If someone is FTM, then refer to him as male and use the pronouns he, him, and his.

Third-- I don't think anyone's arguing that the perpetrator should get a pass because of his gender identity. Groping people, especially under false pretenses is wrong no matter who you are.

Fourth-- Those who say that "transgender doesn't exist"-- well, frankly, no one asked you. Sex and gender are not the same thing. You're right that chromosomal makeup can't be changed, but pretty much every outward sex characteristic (with the exception of bottom surgery for FTMs) can be changed with a high rate of success. Gender is a psychosocial characteristic, and how one feels one needs to express one's gender is not your problem. It neither "breaks your leg nor picks your pocket" (to appropriate a quote from Jefferson) The fact that you think it does indicates transphobia.

Agreeing with Desiree, take it easy! I'm a bit peeved that people jump to attack just from reading an article that brushes the topic of transsexuality... because that's not what the post is about. Neither is posting that link in any way compromising Dr. Grumpy's competence and humour as a human, but maybe there some people were having a bad day and are on edge? I have no different explanation. And yes, I've got a transsexual friend whom I visited especially for her surgery three years ago, so the issue is close to my heart as well. However, this article and the posters intent are harmless and nothing to get so upset and personal (re. Dr.Grumpy) about! Or do you seriously want to question the character of a doc you never met by one out of hundred links he posts? Get real and move on! *eyerolls* (Sorry for the rant.)

Really, *who* accepts free breast exams in a bar? Or anywhere not in a medical office? *That* really is the crux here. If someone had told me that plan beforehand, I'd have said that'll never work. Seems I was wrong. (I guess the answer to the first question is alcohol.)

Alcharisi, thank you. You're right when you say "it is transphobic to disregard their stated identification" - I noticed, too, but am used to people confusing the pronouns, so I didn't pay too much attention (I do, however, rectify such errors when I talk to people face to face and they mistake the pronouns). I think there's still a lot of people who know little about transsexuality, and even more who get totally confused when they hear about people who switched back to their own gender. I'm in med school and had to explain to other students that there are in fact differences between homosexuality, transsexuality etc., and that one does not necessary mean the other applies too, and no, that drag queens again are different.

It's a matter of understanding versus thinking to understand (when actually just reaching for the next cliché).

... I hate it when a link meant to be curious or mind-blowing turns into such a serious discussion. Sigh. Will shut up now.

At a bar on Hallowe'en weekend, a guy had a huge cardboard box over his top half... A figure-eight shape cut into the area in front of his face... And the words, "For a free Mammogram, place breasts here"...

Alcharisi...I will make a special effort to get my transgendered pronouns correct the first time someone with this disorder successfully reproduces as a member of their "chosen" gender instead of their biological one (the "pregnant man" leaps to mind as an example of the latter.)

Oh....and child molesters don't directly impact me as a middle aged person either, but I have trouble with their "choices" as well. Wave a disease in my face and call it "normal", and I darned well WILL have an opinion! I live in a world of science, not rainbows and unicorns.

What? You are comparing child molesters to the transgendered? You are one weird and sick individual.

I speak as a MTF transgendered doctor. The only prejudices I've ever met has been from my own profession. My patients have no probelm.

I did not particulalry find the article transphobic though the responses on here show a certain ignorance at best. I suppose there's the morbid circus like fascination with people perceived as "different" and hencw why iw was mentioned in the article.

Hmm. I thought it mildly offensive that the article made the woman's trans status an issue, but it actually did get her pronouns correct -- it said she is MTF, which means she was identified as male at birth but finds herself to be a woman.

Annie, RN, do you refuse to acknowledge the gender of people who are sterile, since they cannot successfully reproduce as their "chosen" gender?

If you actually did live in this world of science of which you speak and you paid attention to the science of sex characteristics you'd know that the those hormones that you find 'notwithstanding' in trans people are responsible for the whole dog and pony show of sex characteristics, primary and secondary, anyway. It is perfectly possible, and indeed happens regularly, for a person to have XY chromosomes but appear, from birth, as female, and vice-versa. (This happens often enough to become troublesome when Olympic athletes are subjected to genetic sex-tests, uncovering women who were identified as girls at birth, grew up, had normal puberty and so on and are surprised as hell, and offended, to be told that they are male. By the way, would you start calling such a woman "he" if you knew her? How about if she was your daughter?)

If you were really interested in the world of science as it pertains to the phenomenon of transgender people, you'd even be aware that there is excellent evidence of sex-differentiation in the brain, and how this occurs in utero before sex-differentiation of the body really begins. Science shows that it's spectacularly easy to mess it up, at least in rats and cows, by messing with the hormone levels in the womb at the right time during fetal development, resulting in 'female' animals that insist on behaving as males or vice-versa.

If you really want to live in the world of science, it'd be a good idea to stop the snap judgment trip and actually, y'know, INVESTIGATE things.

In the meantime, well, if you saw me you wouldn't know I'm trans, and if you found out and then insisted on using the wrong pronouns, everybody around you would think you were being ridiculous and stupid. This is, functionally, a far better proof of the truth of my gender than my baby-making abilities or technique.

The article does get her pronouns right. It says she's MTF, meaning she was identified as male at birth but finds herself to be female. She's a woman.

Annie, RN:

Do you deny the gender of people who are sterile, or just haven't had any kids?

If you really live in the world of science you ought to know that those hormones that you find 'notwithstanding' in trans people are responsible for the whole dog and pony show of sex anyway. Various hormone-related conditions can, and do, cause people with XX chromosomes to be born with male bits and develop as males, and (more commonly) for people with XY chromosomes to be born female and develop as females. It used to come up every four years when they did genetic gender-testing for the Olympic and the women in question were inevitably shocked to find that they were "genetically male" (whatever the hell that means) and utterly offended (rightfully so) at the suggestion that they are not 'real' women. (By the way, would you start calling such a woman 'he'? Y'know, for science?)

Here in this world of science, people doing science not only know that you can change an embroyos sex regardless of its chromosomes, with hormones, they have also discovered excellent evidence that there are neurological differences in the brains of male and female mammals, and that these bits don't differentiate at the same time as the reproductive tract, and it's all got to do with some hormonal conditions in utero. With the right timing and a syringe of testosterone it is an utter cakewalk to cause 'female' mammals who insist on behaving like males to be born. No amount of pointing out their genitals to them and calling it science will make them stop being behaviorally male.

People who really live in the world of science do not dismiss phenomena that do not make sense to them as non-existent. They investigate.

I teach fetal development, so I think I have a teensy clue about fetal sexual differentiation.

And when the chromosomes are not "XX" or "XY", the fetus is abnormal. Ditto if secondary sexual characteristics do not match genotype...abnormal. A high percentage of spontaneously aborted fetuses have these or other chromosomal mistakes.

You and Chastity/Chaz Bono can mutilate and chemically alter yourselves to your hearts content, thanks to modern medicine. Doesn't change your gender, just your looks.

So look, brother (or sister)....I don't buy what your are selling. And outside of the People's Republic of California....you have more issues than this forum will ever be able to address. And I am done hijacking the blog of the funniest damn doc on the internet!

The blog post didn't bother me--but it terrifies me that a woman who publicly identifies as an RN can be so ignorant and judgmental...

Pattie--have you never heard of intersexed people? Some research indicates that 1 in every 1,000 babies is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male. Biology is NOT destiny, and sexual dimorphism is not the only game in town.

Why is it so hard to be respectful of other people and to accept their perceptions of themselves? As someone noted above, it doesn't cost you anything--but by turning yourself into God and telling people that they cannot be who they are because YOU don't approve, you rob them of dignity and humanity.

As for "Anonymous" above--if you teach fetal development I pity your students. Gender is an assigned social category--not a biological immutable. If you are so ignorant that you don't know that, you have no business teaching anyone.

Transgender people are, without a doubt, the most vulnerable people in our society. They deserve better from healthcare "professionals," who ought to have enough intelligence to do their homework.

"The most vulnerable people in our society' ?? What incredible hubris and self indulgent pathos. Chilren, the elderly poor, and the mentally ill, just for starters, are far more in need of support and compassion...although in your skewed outlook, I'm sure they are sidebars to society.

There is a large parcel of real estate between "ignorance" and a total rejection of your hypothesis of the normalcy of gender reassignment.

So yes...I stand by the claim that transgendered people are the most vulnerable group in the U.S.

And why do you assume that I am not equally concerned about the poor, children, the mentally ill, and the elderly, just because I point out that transgendered people are vulnerable?

I find it interesting that you are so focused on gender binaries (and on constructing straw people) that you didn't answer my question about why you couldn't just treat people the way they wish to be treated--and with dignity. Very telling...and sad.

(I'll not get into the tedious discussion of the meaning of "gender" vs. "sex.")

Hey, I am not saying it's normal. If my gender/sex was normal then I wouldn't need to 'mutilate' and chemically alter myself. I did it because something is wrong and I was constantly in a state of distracted uncomfortable misery because my proprioceptive sense of my sex did not match the facts of my body and my uncontrived behavioral expression of my gender did not match the expectations for people with bodies like mine, creating a mild social disaster.

I didn't do this for a fricking lark, I did it to fix something that's wrong.

Why are you, as a nurse, so unsympathetic to that?

You know enough about fetal development to say what I told you is redundant, then you know enough to know that it is quite possible that trans people are seeking treatment for a real medical problem.

So why the hell do you want to criticize people who seek/get treatment for the problem? Calling Chaz Bono "Chastity" and this criminal woman in the article "he" is socially equivalent to responding to the existence of somebody with a prosthetic hand by deliberately installing doorknobs that people with that sort of prosthetic hand can't work. You don't see somebody who's had plastic surgery for something like electrodactyly and say, "You can mutilate yourself to your heart's content, you're still a lobster-claw kid to me!"

Have a little respect. And maybe offer trans people a little benefit of the doubt. And maybe a little respect for their doctors, too. To get those surgeries and hormones you need a doctor to agree that they're a valid treatment for a valid problem. I didn't get a 'sex change' at a tattoo shop.

Look. My sense of self, which includes my sense of my gender, is as real as yours. The fact that I have had to use medical means to make it function properly in the world is not a good reason to scorn me, much less actively try to undermine my efforts.

Yes, it's a fact, I just changed my appearance. My chromosomes and some of my now-non-functional reproductive tract remain the same as ever. Whoop de do. I'm actually happy and well and functioning completely in society these days, and I stopped smoking and take care of myself and love my body and for the first time in my life I'm not depressed though I was on antidepressants long before I had a so-called sex-change. My doctors and nurses get a big old WIN. Please don't try to break that any more, okay? I really am vulnerable in that attitudes like yours can make it very difficult for me to get work and housing and medical care and avoid being the target of violence.

Accusing Patti of not respecting their dignity is to assume that in face-to-face encounters with these individuals she is discriminatory or rude. You do not have such proof.

I believe I do, since she wrote the following:

Alcharisi...I will make a special effort to get my transgendered pronouns correct the first time someone with this disorder successfully reproduces as a member of their "chosen" gender instead of their biological one (the "pregnant man" leaps to mind as an example of the latter.)

And then there was this one:

You and Chastity/Chaz Bono can mutilate and chemically alter yourselves to your hearts content, thanks to modern medicine.

Do you understand that? Transgendered people who sought medical care from people like Patti were actually denied care outright or verbally harassed because they didn't meet a healthcare provider's standard of "normal"!

That is immoral in my world. I hope it would be immoral to anyone with an ounce of compassion.

As an RN, Patti presumably has a great responsibility for the lives and well-being of her patients. The attitude she has shown here gives me little reason to believe that she would treat a transgendered person with respect (including calling them by their preferred pronoun). I'd love for her to prove me wrong...she could start by actually reading some of the info I've been posting and trying to show a little empathy for our friend in the "Department of Redundancy Department."

If the rest of you really didn't give a flip, you wouldn't point out a person's trans status in news articles about her humorous breast-groping crimes, and you wouldn't start using gendered pronouns that don't match her gendered appearance when you find out that she's trans. If you didn't give a flip, you wouldn't bother doing that stuff.

I eagerly await the day when the rest of you really, truly, don't give a flip, and find the fact that I am a transsexual as boring as I do.

Since I'm already breaking my habit of not being bothered to talk about transsexualism...

About the 'waste of medical resources' argument. Being a transsexual is full of comedy, and one comedic element of my experience is this: My insurance was willing to pay, indefinitely, for me to have talk-therapy for depression and any kind of pricey or cheap drug for it, but, of course, they wouldn't pay for gender-related surgery or hormones. The joke in there is that the cost of the surgery was slightly less than the cost of a year and a half of talk-therapy and a year's worth of hormone therapy is about the price of a single hour. AND this cheaper treatment is the effective one; I am well rather than just coping with being miserable. I go out and hold down a job and do volunteer work and contribute to society and all that good stuff that healthy humans ought to do, instead of being a depressed shut-in. And I paid for the treatment that allowed me to do this out of my own pocket, so, kindly can it about how my well-being is a waste.

The reason the article was transphobic was because the writer felt it appropriate to mention that she was trans. True, the article was better than most in using proper pronouns and didn't show the dreaded before and after photo, but by discussing her medical history the author chose to privelege the gender she was assigned at birth as opposed to her lived experience. You would never see a comparable story that said "Woman assaults other women in bars, also she had an appendectomy 6 years ago." But an article about a trans person will always mention their genitals. Always.

But the original article was only part of the fail that took place in this thread. The original post by Dr. Grumpy was shockingly ignorant and the subsequent posts calling out his shit were completely justified (he has since changed the wording of the post, and at one point posted an apology, which has since been taken down). Not to mention the medical professionals that felt this the appropriate place to laugh about their mistreatment of trans people.

The sad thing was that this was completely foreseeable. The second I (and assuming any of the other trans people) read the linked article, I knew exactly what this thread would turn into. It's a simple formula: 1. Trans person is in the news (usually for being killed or needing to use a restroom) 2. The reporter decides that everybody needs to know about this person's genitals. 3. Cis commenters swarm to compete to see who can be the most vile.

Go read the comments of the original article and you can see exactly what I'm talking about. A few commenters stick to the original crime, but in no time the thread devolves into transphobic slurs, denying her gender (ie using male pronouns), denying her humanity (ie calling her "it"), joking about assaulting her, and joking about throwing her in a men's prison (which is a very real threat for trans people).

Did anyone actually think this thread would be any different just because the blog is followed by medical professionals? I sure didn't. I've had plenty of interactions with medical folk since coming out, and the last word I would use to describe them (the interactions or the people) would be 'decent'.

Instead of arguing about how an article isn't transphobic (even when there are plenty of trans people saying that it is), how about trying to educate yourselves? There are tons of resouces out there, books, articles, blogs, etc, that are written by trans people. But overall there's a lack of people in the medical profession that are willing to look at them. The sad thing is that the only people still paying attention to this thread are either the transphobes or the trans people calling them out. But that's the whole point. Cis people don't have to be knowledgeable about this stuff, so they can just pass on by and will be just as ignorant next time.

Cis people don't have to be knowledgeable about this stuff, so they can just pass on by and will be just as ignorant next time.

For the record, I'm cis. :-)

(For the uninitiated, that means the gender I perceive myself to be matches the physical body I was born with. In this case, female.)

I'm adamant about standing up for trans people because I believe everyone should be treated with dignity--ESPECIALLY by people who have chosen jobs in which they are responsible for the physical and mental well-being of others. Simple as that.

I've never had medical professionals be actively rude to me, but your experience is probably more typical for trans people. A trans friend of mine broke an ankle and had an ER doctor demand, "What makes you think you deserve health care?!"

My own experience is just full of the polite variants on, "We don't treat your kind." Never mind that my care is simple and there's no need to do anything about my trans-ness but write a script so I can continue a well-established regimen.

The trans-comedy-gold award for this thread goes to Patti, RN, talking about how trans people aren't vulnerable, "the elderly poor!" etc. Last time I changed primary care docs I had a terrible time finding somebody who would treat me. After searching for over two months I ended up at the clinic especially established to serve vulnerable populations who might otherwise be denied health care. The vast majority of my doctor's other patients are homeless. He knows, and the staff know, that my comfortably middle-class behind is at just as much risk of being turned away from a doctor as the unwashed and penniless behinds of my fellow patients. My doctor, and the whole crew there, are frickin' great.

And no, assorted ridiculous hateful people, I am not taking resources from the poor. They charge people who, like me, can afford it, a profitable price and use that profit to help subsidize those who cannot afford it. And they accept my hideous mutilated donations.

I have just been lurking and reading, cuz it is not normal for this blog to have not funny comments and it is humor and makes me laugh most of the time.

I am just an average middle aged man and don't think about this craziness much at all but it seems like the people who have had this surgery and shots and stuff are awfully nasty to them other people that think that they are wierd. I mean that I think it IS wierd to cut yourself up because you are messed up somehow about who you are.

Buddy, you don't really expect me and the world to think you are normal, do you? I mean, live your life, but don't be crazy enough to think that normal people are going to applaud or something. I think you have some problems for sure, and maybe if you didn't bitch at all these other people who think you are wierd they wouldn't be tickked off. It seems like you all are trying to fight with other people about the way they THINK. There are laws and stuff but you don't change peoples minds by being an ass or whining.

Why the heck do you think I expect you to think it's not weird? It is damn weird.

Think it's weird all you want. What I want is to be treated as a full-fledged respect-worthy human being in spite of the fact that it's weird. This includes not making fun of my problem, not pretending that it's all that I am, not blaming me for it, not trying to aggravate it, not suggesting that I deserve to be murdered or raped, not saying that I don't deserve medical care, and not calling me 'it,' a dehumanizing pronoun that is likely to offend someone if you apply it to their dog.

On the lesser scale, I also want you to just stop making a big deal of it. The same way my friend with Parkinson's (which is weird) wants to be permitted to not talk about Parkinson's all the damn time. It gets really old.

Thing is, people who claim that the fact that transgenderism is weird is an excuse to treat trans people like dirty, worthless jokes believe that it is some sort of 'lifestyle choice' and that trans people do it because they want to be weird. What you are doing is mistaking the treatment for the disease, and pretending that illness is a voluntary condition.

You do not suppose that my colleague who had a knee-replacement had the surgery because she wanted a cool artificial knee and a cool scar, and that she's using a cane because she's got this crazy weird desire to be different and have a cane, and that she took pain meds because it's fun. She did that stuff so she can live with less pain.

It is for the same reason that I had a 'sex change.' I was in pain. I wanted to die. If I could have been the gender I was assigned at birth without living in unending and ever-increasing misery, I would have. I tried and I tried some more.

I didn't get a sex change to be different. I didn't do it because I thought it was a cool thing to do. Getting a sex change is not like getting a tattoo. I did it because the doctors and scientists who study this really weird condition that I've got say it is the only treatment that is effective consistently and in the long term. Guess what? They were right. To me the absolutely weirdest thing about this is discovering just how good it feels, and how freeing it is, to have so much less pain. I never imagined it would work so damn well. It's weird as hell that it does.

So. Yes. I am going to be awfully nasty to people who tell me that I ought to live with debilitating pain so I can not be weird.* I am also going to be awfully nasty to people who try to cause me to have pain and trouble in order to punish me for being weird.

*Never mind that my inability to perform by birth-assigned gender correctly made me weirder then than I am now, at least to people who don't know I am transsexual, which is most of them.

From a cis woman (who happens to be a lesbian): many thanks to both the trans folks and the cis folks in this comment thread who are being fantastic advocates for trans equality and doing a great job of educating cisgender folks about the reality of transgender folks' lives. Thank you for your patience and your plain speaking. You rock.

For every person who comments who doesn't get it, you will have sown a seed for at least one lurker.

Folks for whom this is a big mystery, or for whom this is acutely uncomfortable: for many cisgender people, reaching a certain level of understanding about the reality of trans people's lives is a process. It doesn't happen overnight, it doesn't happen, poof!, all of a sudden. Give yourself time to think about it. Read info at some of the links some of the transgender commenters have posted. Read about and listen to the real, lived experience of trans people, and believe that lived experience, not just what's in your head about what "ought" to be and what society has taught us all about what "ought" to be. Think about some of the other things society used to teach us that has turned out not to be true.

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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